Identify Patients At Risk of Fatal Heart Attacks

Cardiovascular disease is a class of diseases that involve the heart or blood vessels (arteries and veins). Cardiovascular disease refers to any disease that affects the cardiovascular system, principally cardiac disease, vascular diseases of the brain and kidney, and peripheral arterial disease. The causes of cardiovascular disease are diverse but atherosclerosis and/or hypertension are the most common.
 
Cardiovascular diseases remain the biggest cause of deaths worldwide, though over the last two decades, cardiovascular mortality rates have declined in many high-income countries. At the same time cardiovascular deaths and disease have increased at an astonishingly fast rate in low- and middle-income countries. Although cardiovascular disease usually affects older adults, the antecedants of cardiovascular disease, notably atherosclerosis begin in early life, making primary prevention efforts necessary from childhood. There is therefore increased emphasis on preventing atherosclerosis by modifying risk factors, such as healthy eating, exercise, and avoidance of smoking.
 
Almost all cardiovascular disease in a population can be explained in terms of a limited number of risk factors: age, gender, high blood pressure, high serum cholesterol levels, tobacco smoking, excessive alcohol consumption, family history, obesity, lack of physical activity, psychosocial factors, diabetes mellitus, air pollution. While the individual contribution of each risk factor varies between different communities or ethnic groups the consistency of the overall contribution of these risk factors is remarkably strong. Some of these risk factors, such as age, gender or family history are immutable, however many important cardiovascular risk factors are modifiable by lifestyle change, drug treatment or social change.
 
A new study indicates dentists can play a potentially life-saving role in health care by identifying patients at risk of fatal heart attacks and referring them to physicians for further evaluation. 
 
Published in the November issue of the Journal of the American Dental Association, the study followed 200 patients (101 women and 99 men) in private dental practices in Sweden whose dentists used a computerized system, "HeartScore," to calculate the risk of a patient dying from a cardiovascular event within a 10-year period. 
 
Designed by the European Society of Cardiology, HeartScore measures cardiovascular disease risk in persons aged 40-65 by factoring the person's age, sex, total cholesterol level, systolic blood pressure and smoking status. 
 
Patients with HeartScores of 10 percent or higher, meaning they had a 10 percent or higher risk of having a fatal heart attack or stroke within a 10-year period, were told by dentists to seek medical advice regarding their condition. 
 
Twelve patients in the study, all of them men, had HeartScores of 10 percent or higher. All women participating in the study had HeartScores of 5 percent or less. 
 
Of the 12 male patients with HeartScores of 10 percent or higher, nine sought further evaluation by a medical care provider who decided that intervention was indicated for six of the patients. Two patients did not follow the dentist's recommendation to seek further medical evaluation and one patient was only encouraged by his dentist to discontinue smoking. Physicians for three patients were not able to confirm their risk for cardiovascular disease. 
 
All 200 patients enrolled in the study were 45 years of age or older with no history of cardiovascular disease, medications for high blood pressure, high cholesterol or diabetes and had not visited a physician during the previous year to assess their glucose, cholesterol or blood pressure levels. 
 
The study's authors conclude that oral health care professionals can identify patients who are unaware of their risk of developing serious complications as a result of cardiovascular disease and who are in need of medical interventions. 
 
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